Publications by authors named "Xicheng Song"

80 Publications

Cervical lymphangioma in adults: A report of seven cases and review of the literature.

Laryngoscope Investig Otolaryngol 2022 Jun 22;7(3):751-756. Epub 2022 Apr 22.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital Qingdao University Yantai China.

Background: Cervical lymphangioma usually occurs in children and is relatively rare in adults. The purpose of this study was to investigate the characteristics of cervical lymphangiomas in adults.

Methods: We retrospectively reviewed the medical records and analyzed clinical data obtained from seven adult patients who suffered from cervical lymphangioma from January 2008 to June 2021.

Results: Five (71.43%) of seven cases were asymptomatic and four (57.14%) lymphangiomas had a maximum diameter ≥ 10 cm. Each cervical lymphangioma was located adjacent to the carotid sheath. All the cervical lymphangiomas were completely surgically excised and were pathologically diagnosed as cystic lymphangioma. After a median 32 months follow-up period, no recurrence was observed.

Conclusion: Cervical lymphangiomas from adults are often large asymptomatic masses infiltrating or adjacent to surrounding vital structures which brings many difficulties to the surgery, requiring an experienced surgeon to remove the mass.
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http://dx.doi.org/10.1002/lio2.801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194990PMC
June 2022

Extrathyroidal Extension Prediction of Papillary Thyroid Cancer With Computed Tomography Based Radiomics Nomogram: A Multicenter Study.

Front Endocrinol (Lausanne) 2022 1;13:874396. Epub 2022 Jun 1.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Objectives: To develop and validate a Computed Tomography (CT) based radiomics nomogram for preoperative predicting of extrathyroidal extension (ETE) in papillary thyroid cancer (PTC) patients.

Methods: A total of 153 patients were randomly assigned to training and internal test sets (7:3). 46 patients were recruited to serve as an external test set. A radiologist with 8 years of experience segmented the images. Radiomics features were extracted from each image and Delta-radiomics features were calculated. Features were selected by using one way analysis of variance and the least absolute shrinkage and selection operator in the training set. K-nearest neighbor, logistic regression, decision tree, linear-support vector machine (linear -SVM), gaussian-SVM, and polynomial-SVM were used to build 6 radiomics models. Next, a radiomics signature score (Rad-score) was constructed by using the linear combination of selected features weighted by their corresponding coefficients. Finally, a nomogram was constructed combining the clinical risk factors with Rad-scores. Receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve were performed on the three sets to evaluate the nomogram's performance.

Results: 4 radiomics features were selected. The six models showed the certain value of radiomics, with area under the curves (AUCs) from 0.642 to 0.701. The nomogram combining the Rad-score and clinical risk factors (radiologists' interpretation) showed good performance (internal test set: AUC 0.750; external test set: AUC 0.797). Calibration curve and DCA demonstrated good performance of the nomogram.

Conclusion: Our radiomics nomogram incorporating the radiomics and radiologists' interpretation has utility in the identification of ETE in PTC patients.
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http://dx.doi.org/10.3389/fendo.2022.874396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9198261PMC
June 2022

A Global Regulatory Network for Dysregulated Gene Expression and Abnormal Metabolic Signaling in Immune Cells in the Microenvironment of Graves' Disease and Hashimoto's Thyroiditis.

Front Immunol 2022 26;13:879824. Epub 2022 May 26.

Department of Endocrinology, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai, China.

Background: Although the pathogenetic mechanisms of Hashimoto's thyroiditis (HT) and Graves' disease (GD) have been elucidated, the molecular mechanisms by which the abnormal immune function of cellular subpopulations trigger an autoimmune attack on thyroid tissue largely remains unexplained.

Methods: The study included 2 HT patients, 2 GD patients, and 1 control donor. The thyroid samples were extracted for single-cell RNA sequencing, whole transcriptome, full-length transcriptome (Oxford Nanopore Technologies), and metabolome sequencing. Identification of immune cells with dysregulated gene expression and abnormal metabolic signaling was performed in the microenvironment, both at the bulk and single-cell levels. Based on functional enrichment analysis, the biological processes and pathways involved in abnormal immune cells were further explored. Finally, according to cell communication analysis, the global regulatory network of immune cells was constructed.

Results: CD4 T cells, CD8 T cells, and macrophages were abnormally increased in patients with HT and GD. The differentially expressed genes of these cells were significantly involved in signaling pathways, including Th1 and Th2 cell differentiation, Th17 cell differentiation, cytokine-cytokine receptor interaction, and NF-kappa B signaling pathway. Moreover, in HT, CD4 T cells interact with macrophages the IL16-CCR5/FGF10-FGFR1/CXCL13-CXCR3 axis, and macrophages interact with CD8 T cells the CD70-CD27 axis, thereby activating the T-cell receptor signaling pathway and NF-kappa B signaling pathway. In GD, CD4 T cells interact with macrophages the CXCR3-CXCL10/PKM-CD44/MHCII-NFKBIE axis, and macrophages interact with CD8 T cells the IFNG-IFNGR1/CCR7-CCL21 axis, thereby activating T-cell receptor signaling pathway, Th1 and Th2 cell differentiation, and chemokine signaling pathway.

Conclusion: In HT and GD, immune dysregulated cells interact and activate relevant immune pathways and further aggravate the immune response. This may trigger the immune cells to target the thyroid tissue and influence the development of the disease.
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http://dx.doi.org/10.3389/fimmu.2022.879824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204353PMC
May 2022

Identification of a lncRNA AC011511.5- Mediated Competitive Endogenous RNA Network Involved in the Pathogenesis of Allergic Rhinitis.

Front Genet 2022 31;13:811679. Epub 2022 May 31.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

LncRNA-miRNA-mRNA competing endogenous RNA (ceRNA) networks are thought to be involved in regulating the development of various inflammatory diseases. Up to now, the mechanism of such a network in allergic rhinitis (AR) remains unclear. In the study, we investigated the differential expression of lncRNAs (DElncRNAs) and mRNAs (DEmRNAs) by performing a microarray analysis of peripheral blood obtained from AR patients and healthy control subjects. StarBase 2.0 was used to predict miRNAs that might interact with various DElncRNAs and DEmRNAs. We constructed a ceRNA network based on potential lncRNA-miRNA-mRNA interactions. The Cluster Profiler R package was used to perform a functional enrichment analysis of the hub-ceRNA, and Molecular Complex Detection (MCODE) was used for further identification of the hub-ceRNA network. The expression levels of genes contained in the hub-ceRNA network were validated by RT-PCR. In total, 247 DEmRNAs and 18 DelncRNAs were aberrantly expressed in the PBMCs of AR patients. A ceRNA network consisting of 3 lncRNAs, 45 miRNAs, and 75 mRNAs was constructed. A GO analysis showed that negative regulation of immune response, response to interferon-beta, and response to interferon-alpha were important terms. A KEGG pathway analysis showed that 75 mRNAs were significantly enriched in "NOD-like receptor signaling pathway" and "tryptophan metabolism". Ultimately, a hub-ceRNA network was constructed based on 1 lncRNA (AC011511.5), 5 miRNAs (hsa-miR-576-5p, hsa-miR-520c-5p, hsa-miR-519b-5p, hsa-miR-519c-5p, and hsa-miR-518d-5p), and 2 mRNAs (ZFP36L1 and SNX27). Following further verification, we found that overexpression of lncRNA AC011511.5 or inhibitor of miR-576-5p upregulated SNX27 expression. The expression of SNX27 in the lncRNA AC011511.5 overexpression & miR-576-5p inhibitor group was not different from that in the miR-576-5p inhibitor group or lncRNA AC011511.5 overexpression group, indicating that overexpression of lncRNA AC011511.5 could not further upregulate the expression of SNX27 in miR-576-5p inhibitor Jurkat cells. This network may provide new insights to search for biomarkers that can be used for the diagnosis and clinical treatment of AR.
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http://dx.doi.org/10.3389/fgene.2022.811679DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194448PMC
May 2022

Radiomics Analysis of Computed Tomography for Prediction of Thyroid Capsule Invasion in Papillary Thyroid Carcinoma: A Multi-Classifier and Two-Center Study.

Front Endocrinol (Lausanne) 2022 25;13:849065. Epub 2022 May 25.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Objective: To investigate the application of computed tomography (CT)-based radiomics model for prediction of thyroid capsule invasion (TCI) in papillary thyroid carcinoma (PTC).

Methods: This retrospective study recruited 412 consecutive PTC patients from two independent institutions and randomly assigned to training (n=265), internal test (n=114) and external test (n=33) cohorts. Radiomics features were extracted from non-contrast (NC) and artery phase (AP) CT scans. We also calculated delta radiomics features, which are defined as the absolute differences between the extracted radiomics features. One-way analysis of variance and least absolute shrinkage and selection operator were used to select optimal radiomics features. Then, six supervised machine learning radiomics models (k-nearest neighbor, logistic regression, decision tree, linear support vector machine [L-SVM], Gaussian-SVM, and polynomial-SVM) were constructed. Univariate was used to select clinicoradiological risk factors. Combined models including optimal radiomics features and clinicoradiological risk factors were constructed by these six classifiers. The prediction performance was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results: In the internal test cohort, the best combined model (L-SVM, AUC=0.820 [95% CI 0.758-0.888]) performed better than the best radiomics model (L-SVM, AUC = 0.733 [95% CI 0.654-0.812]) and the clinical model (AUC = 0.709 [95% CI 0.649-0.783]). Combined-L-SVM model combines 23 radiomics features and 1 clinicoradiological risk factor (CT-reported TCI). In the external test cohort, the AUC was 0.776 (0.625-0.904) in the combined-L-SVM model, showing that the model is stable. DCA demonstrated that the combined model was clinically useful.

Conclusions: Our combined model based on machine learning incorporated with CT radiomics features and the clinicoradiological risk factor shows good predictive ability for TCI in PTC.
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http://dx.doi.org/10.3389/fendo.2022.849065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174423PMC
May 2022

Radiomics Model for Predicting TP53 Status Using CT and Machine Learning Approach in Laryngeal Squamous Cell Carcinoma.

Front Oncol 2022 28;12:823428. Epub 2022 Apr 28.

Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.

Objective: We aim to establish and validate computed tomography (CT)-based radiomics model for predicting TP53 status in patients with laryngeal squamous cell carcinoma (LSCC).

Methods: We divided all patients into a training set 1 (n=66) and a testing set 1 (n=30) to establish and validate radiomics model to predict TP53. Radiomics features were selected by analysis of variance (ANOVA) and the least absolute shrinkage and selection operator (Lasso) regression analysis. Five radiomics models were established by using K-Nearest Neighbor, logistics regressive, linear-support vector machine (SVM), gaussian-SVM, and polynomial-SVM in training set 1. We also divided all patients into a training set 2 and a testing set 2 according to different CT equipment to establish and evaluate the stability of the radiomics models.

Results: After ANOVA and subsequent Lasso regression analysis, 22 radiomics features were selected to build the radiomics model in training set 1. The radiomics model based on linear-SVM has the best predictive performance of the five models, and the area under the receiver operating characteristic curve in training set 1 and testing set 1 were 0.831(95% confidence interval [CI] 0.692-0.970) and 0.797(95% CI 0.632-0.957) respectively. The specificity, sensitivity, and accuracy were 0.971(95% CI 0.834-0.999), 0.714(95% CI 0.535-0.848), and 0.843(95% CI 0.657-0.928) in training set 1 and 0.750(95% CI 0.500-0.938), 0.786(95% CI 0.571-1.000), and 0.667(95% CI 0.467-0.720) in testing set 1, respectively. In addition, the radiomics model also achieved stable prediction results even in different CT equipment. Decision curve analysis showed that the radiomics model for predicting TP53 status could benefit LSCC patients.

Conclusion: We developed and validated a relatively optimal radiomics model for TP53 status prediction by trying five different machine learning methods in patients with LSCC. It shown great potential of radiomics features for predicting TP53 status preoperatively and guiding clinical treatment.
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http://dx.doi.org/10.3389/fonc.2022.823428DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9095903PMC
April 2022

H55 N variation in citrate synthase leads to decrement in the enzyme activity and transport rate to mitochondria in HEI-OC1 cells.

Biochem Biophys Res Commun 2022 07 26;612:134-140. Epub 2022 Apr 26.

Key Laboratory for Genetic Hearing Disorders in Shandong, Department of Biochemistry and Molecular Biology, Binzhou Medical University, 346 Guanhai Road, Yantai, 264003, Shandong, PR China. Electronic address:

A/J mouse is a typical animal model of age-related deafness. Previous studies have shown that the mice suffer from progressive hearing loss and degeneration of cochlear cells, and a variation of H55 N in citrate synthase (CS) causes about 40% the hearing loss. CS is a key enzyme in the tricarboxylic acid cycle, which is transported from cytoplasm to mitochondria after synthesis, sorted by the mitochondrial targeting sequence (MTS). To explore the mechanism of CS (H55 N) variation in affecting its function, HEI-OC1 cells were infected with lentivirus particles to express CS-Flag or CS(H55 N)-Flag. The results showed that H55 N variation in CS, as purified by co-immunoprecipitation, decreased the enzyme activity by about 50%. Confocal microscope co-localization indicated that the CS (H55 N) variation led to a decrement in its mitochondrial content. Western blot also showed the amount of CS(H55 N)-Flag was more than that of CS(WT)-Flag in the cytosol. The results suggest H55 N variation in CS lead to decrement of its enzyme activity and targeting transport to mitochondria. We therefore conclude that decrement in CS activity and mitochondrial delivery contributes to the degeneration of cochlear cells and thus the hearing loss in A/J mice.
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http://dx.doi.org/10.1016/j.bbrc.2022.04.104DOI Listing
July 2022

Identification of a circRNA/miRNA/mRNA ceRNA Network as a Cell Cycle-Related Regulator for Chronic Sinusitis with Nasal Polyps.

J Inflamm Res 2022 23;15:2601-2615. Epub 2022 Apr 23.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, People's Republic of China.

Purpose: To explore the mechanisms by which circRNA/miRNA/mRNA competitive endogenous RNAs (ceRNA) networks regulate CRSwNP.

Methods: The expression profiles of circRNAs, miRNAs, and mRNAs from patients with CRSwNP and control subjects were acquired from the Gene Expression Omnibus database. The circRNA/miRNA/mRNA ceRNA network was constructed based on the predicted circRNA-miRNA interactions and miRNA-mRNA interactions. Hub-mRNAs were screened by protein-protein interaction network analysis and Cytoscape molecular complex detection. The expression of factors in tissue and in hsa_circ_0031594 siRNA transfection cells was verified by RT-qPCR and the association between them was revealed by Spearman correlation analysis. Receiver operating characteristic curve analysis was performed with the pROC R package.

Results: The differential expression of 5423 circRNAs, 415 miRNAs, and 3673 mRNAs was identified in CRSwNP subjects compared to control subjects. Among these, 9 circRNAs, 39 miRNAs, and 78 mRNAs were screened to construct a ceRNA network. Ultimately, a subnetwork including circRNA hsa_circ_0031594, hsa-miR-1260b, hsa-miR-6507-5p, NCAPG2, RACGAP1, CHEK1 and PRC1 was screened out. RT-qPCR validated that the expression of hsa_circ_0031594, NCAPG2, PRC1 was significantly increased, and hsa-miR-1260b and hsa-miR-6507-5p were expressed significantly less in patients with CRSwNP than in control subjects. In addition, the AUCs of hsa_circ_0031594, hsa-miR-1260b, hsa-miR-6507-5p, NCAPG2, and PRC1 to discriminate CRSwNP patients were 0.995, 0.842, 0.862, 0.765, and 0.816. Spearman correlation showed that the expression of hsa_circ_0031594 was negatively correlated with hsa-miR-1260b and hsa-miR-6507-5p, and positively correlated with NCAPG2 and PRC1. In human nasal epithelial cell (HNEpC) line, knocking down hsa_circ_0031594 could increase the expression of hsa-miR-1260b and hsa-miR-6507-5p, and reduce the expression of NCAPG2 and PRC1.

Conclusion: CeRNA networks including hsa_circ_0031594, hsa-miR-1260b, and NCAPG2, and hsa_circ_0031594, hsa-miR-6507-5p, and PRC1 may be key regulators for CRSwNP occurrence, and may be potential targets for the pathogenesis and treatment development of CRSwNP.
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http://dx.doi.org/10.2147/JIR.S358387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9045834PMC
April 2022

Atypical Stevens-Johnson syndrome characterized by mucosal ulcerations of the pharynx and larynx: A case report and literature review.

Ear Nose Throat J 2022 Feb 16:1455613221079512. Epub 2022 Feb 16.

Department of Otolaryngology Head and Neck Surgery, 117747Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong, China.

By summarizing and analyzing the diagnostic and treatment process of a case with atypical Stevens-Johnson syndrome (SJS) characterized by mucosal ulcerations of the pharynx and larynx, and reviewing related literature, we would like to remind that in the presence of unexplained mucosal lesions, atypical SJS should not be ignored.
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http://dx.doi.org/10.1177/01455613221079512DOI Listing
February 2022

Seasonal distribution of inhaled allergens in allergic asthma patients with or without allergic rhinitis.

Chin Med J (Engl) 2021 Dec 15. Epub 2021 Dec 15.

Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, China Department of Otolaryngology, Head and Neck Surgery, Laishan Branch of Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, China Department of Allergy, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, China Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, Shandong, China Department of Oto-Rhino Laryngology, Upper Airways Research Laboratory, Ghent University and Ghent University Hospital, Ghent, Belgium Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden.

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http://dx.doi.org/10.1097/CM9.0000000000001894DOI Listing
December 2021

Identification and Validation of 17-lncRNA Related to Regulatory T Cell Heterogeneity as a Prognostic Signature for Head and Neck Squamous Cell Carcinoma.

Front Immunol 2021 22;12:782216. Epub 2021 Nov 22.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Successful eradication of tumors by the immune system depends on generation of antigen-specific T cells that migrate to tumor sites and kill cancerous cells. However, presence of suppressive Treg populations inside tumor microenvironment hinders effector T cell function and decreases antitumor immunity. In this study we independently evaluated and confirmed prognostic signature of 17-Treg-related-lncRNA. Immune cell infiltration analysis using 17-lncRNA signature as a probe, accurately described Treg populations in tumor immune microenvironment. 17-lncRNA signature model predicted prognosis with excellent accuracy in all three cohorts: training cohort (AUC=0.82), testing cohort (AUC=0.61) and total cohort (AUC=0.72). The Kaplan-Meier analysis confirmed that the overall survival of patients in the low-risk group was significantly better than those in the high-risk group(P<0.001). CIBERSORT analysis confirmed that low risk group had higher infiltration of tumor killer CD8 T cells, memory activated CD4 T cells, follicular helper T cells and T cells regulatory (Tregs), and lower expression of M0 macrophages and Mast cells activated. These results indicate that the 17-lncRNA signature is a novel prognostic and support the use of lncRNA as a stratification tool to help guide the course of treatment and clinical decision making in patients at high risk of HNSCC.
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http://dx.doi.org/10.3389/fimmu.2021.782216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645855PMC
February 2022

Hippocampal Transcriptome-Wide Association Study Reveals Correlations Between Impaired Glutamatergic Synapse Pathway and Age-Related Hearing Loss in BXD-Recombinant Inbred Mice.

Front Neurosci 2021 17;15:745668. Epub 2021 Nov 17.

Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, United States.

Age-related hearing loss (ARHL) is associated with cognitive dysfunction; however, the detailed underlying mechanisms remain unclear. The aim of this study is to investigate the potential underlying mechanism with a system genetics approach. A transcriptome-wide association study was performed on aged (12-32 months old) BXD mice strains. The hippocampus gene expression was obtained from 56 BXD strains, and the hearing acuity was assessed from 54 BXD strains. Further correlation analysis identified a total of 1,435 hearing-related genes in the hippocampus ( < 0.05). Pathway analysis of these genes indicated that the impaired glutamatergic synapse pathway is involved in ARHL ( = 0.0038). Further gene co-expression analysis showed that the expression level of glutamine synthetase (), which is significantly correlated with ARHL ( = 26, = -0.46, = 0.0193), is a crucial regulator in glutamatergic synapse pathway and associated with learning and memory behavior. In this study, we present the first systematic evaluation of hippocampus gene expression pattern associated with ARHL, learning, and memory behavior. Our results provide novel potential molecular mechanisms involved in ARHL and cognitive dysfunction association.
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http://dx.doi.org/10.3389/fnins.2021.745668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636065PMC
November 2021

Individualized airway atomization improves preoperative lung dysfunction in patients with chronic rhinosinusitis with nasal polyps.

Int Forum Allergy Rhinol 2022 Jun 10;12(6):880-882. Epub 2021 Dec 10.

Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

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http://dx.doi.org/10.1002/alr.22924DOI Listing
June 2022

Computed Tomography-Based Radiomics Model to Predict Central Cervical Lymph Node Metastases in Papillary Thyroid Carcinoma: A Multicenter Study.

Front Endocrinol (Lausanne) 2021 21;12:741698. Epub 2021 Oct 21.

Department of Otorhinolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Objectives: This study aimed to develop a computed tomography (CT)-based radiomics model to predict central lymph node metastases (CLNM) preoperatively in patients with papillary thyroid carcinoma (PTC).

Methods: In this retrospective study, 678 patients with PTC were enrolled from Yantai Yuhuangding Hot3spital (n=605) and the Affiliated Hospital of Binzhou Medical University (n=73) within August 2010 to December 2020. The patients were randomly divided into a training set (n=423), an internal test set (n=182), and an external test set (n=73). Radiomics features of each patient were extracted from preoperative plain scan and contrast-enhanced CT images (arterial and venous phases). One-way analysis of variance (ANOVA) and least absolute shrinkage and selection operator algorithm were used for feature selection. The K-nearest neighbor, logistics regression, decision tree, linear-support vector machine (linear-SVM), Gaussian-SVM, and polynomial-SVM algorithms were used to establish radiomics models for CLNM prediction. The clinical risk factors were selected by ANOVA and multivariate logistic regression. Incorporated with clinical risk factors, a combined radiomics model was established for the preoperative prediction of CLNM in patients with PTCs. The performance of the combined radiomics model was evaluated using the receiver operating characteristic (ROC) and calibration curves in the training and test sets. The clinical usefulness was evaluated through decision curve analysis (DCA).

Results: A total of 4227 radiomic features were extracted from the CT images of each patient, and 14 non-zero coefficient features associated with CLNM were selected. Four clinical variables (sex, age, tumor diameter, and CT-reported lymph node status) were significantly associated with CLNM. Linear-SVM led to the best prediction model, which incorporated radiomic features and clinical risk factors. Areas under the ROC curves of 0.747 (95% confidence interval [CI] 0.706-0.782), 0.710 (95% CI 0.634-0.786), and 0.764 (95% CI 0.654-0.875) were obtained in the training, internal, and external test sets, respectively. The linear-SVM algorithm also showed better sensitivity (0.702 [95% CI 0.600-0.790] 0.477 [95% CI 0.409-0.545]) and accuracy (0.670 [95% CI 0.600-0.738] 0.642 [95% CI 0.569-0.712]) than an experienced radiologist in the internal test set in the combined radiomics model. The calibration plot reflected a favorable agreement between the actual and estimated probabilities of CLNM. The DCA indicated the clinical usefulness of the combined radiomics model.

Conclusion: The combined radiomics model is a non-invasive preoperative tool that incorporates radiomic features and clinical risk factors to predict CLNM in patients with PTC.
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http://dx.doi.org/10.3389/fendo.2021.741698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567994PMC
February 2022

miR-146a enhances regulatory T-cell differentiation and function in allergic rhinitis by targeting STAT5b.

Allergy 2022 02 6;77(2):550-558. Epub 2021 Nov 6.

Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Background: MicroRNA (miR)-146a, as an important immune regulatory factor with an anti-inflammatory effect, plays a crucial role in regulatory T-cell (Tregs) differentiation and function in allergic rhinitis (AR). The present study aimed to investigate the regulatory mechanism employed by miR-146a to control Treg differentiation and function in AR.

Methods: Expression of miR-146a and STAT5b in peripheral blood mononuclear cells (PBMCs) and nasal mucosa from patients with AR was detected by qPCR and Western blotting. Tregs were quantified by flow cytometry in miR-146a knockdown or STAT5b knockdown PBMCs. FOXP3, IL-10, and TGF-β levels were detected by Western blotting or ELISA in miR-146a knockdown or STAT5b overexpressing PBMCs, as well as in STAT5b knockdown PBMCs overexpressing miR-146a. The effect of miR-146a on STAT5b was observed by luciferase assay and knockdown experiments.

Results: Levels of miR146a and STAT5b in the nasal mucosa or PBMCs were significantly lower in the AR group than in the control group. There were significantly fewer Tregs in miR-146a knockdown or STAT5b knockdown PBMCs compared to control PBMCs. Expression of FOXP3, IL-10, and TGF-β was decreased in the miR-146a knockdown group but increased in the STAT5b overexpression group. In contrast, miR-146a overexpression increased the levels of these factors, but knockdown of STAT5b significantly inhibited this effect. Luciferase assay and knockdown experiments showed that miR-146a bound directly to STAT5b.

Conclusions: miR-146a enhances Treg differentiation and function in AR by positively targeting STAT5b.
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http://dx.doi.org/10.1111/all.15163DOI Listing
February 2022

Pregnancy leads to changes in the brain functional network: a connectome analysis.

Brain Imaging Behav 2022 Apr 30;16(2):811-819. Epub 2021 Sep 30.

Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, No. 20 Yuhuangding road, Yantai, Shandong, 264000P, People's Republic of China.

Pregnancy leads to long-lasting changes in human brain structure; however, little is known regarding alterations in the topological organization of functional networks. In this study, we investigated the effect of pregnancy on human brain function networks. Resting-state fMRI data was collected from eighteen primiparous mothers and twenty-four nulliparous control women of similar age, education level and body mass index (BMI). The functional brain network and topological properties were calculated by using GRETNA toolbox. The demographic data differences between two groups were computed by the independent two sample t-test. We tested group differences in network metrics' area under curve (AUC) using non-parametric permutation test of 1,000 permutations and corrected for false discovery rate (FDR). Differences in regional networks between groups were evaluated using non-parametric permutation tests by network-based statistical analysis (NBS). Compared with the nulliparous control women, a hub node changed from left inferior temporal gyrus to right precentral gyrus in primiparous mothers, while primiparous mothers showed enhanced network global efficiency (p = 0.247), enhanced local efficiency (p = 0.410), larger clustering coefficient (p = 0.410), but shorter characteristic path length (p = 0.247), smaller normalized clustering coefficient (p = 0.111), and shorter normalized characteristic path length (p = 0.705). Although both groups of functional networks have small-world property (σ > 1), the σ values of primiparous mothers were decreased significantly. NBS evaluation showed the majority of altered connected sub-network in the primiparous mothers occurred in the bilateral frontal lobe gyrus (p < 0.05). Altered functional network metrics and an abnormal sub-network were found in primiparous mothers, suggested that pregnancy may lead to changes in the brain functional network.
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http://dx.doi.org/10.1007/s11682-021-00561-1DOI Listing
April 2022

Mammography-based radiomics for predicting the risk of breast cancer recurrence: a multicenter study.

Br J Radiol 2021 Nov 14;94(1127):20210348. Epub 2021 Sep 14.

Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Objective: This study aimed to establish a mammography-based radiomics model for predicting the risk of estrogen receptor (ER)-positive, lymph node (LN)-negative invasive breast cancer recurrence based on Oncotype DX and validated it by using multicenter data.

Methods: A total of 304 potentially eligible patients with pre-operative mammography images and available Oncotype DX score were retrospectively enrolled from two hospitals. The patients were grouped as training set (168 patients), internal test set (72 patients), and external test set (64 patients). Radiomics features were extracted from the mammography images of each patient. Spearman correlation analysis, analysis of variance, and least absolute shrinkage and selection operator regression were performed to reduce the redundant features in the training set, and the least absolute shrinkage and selection operator algorithm was used to construct the radiomics signature based on selected features. Multivariate logistic regression was utilized to construct classification models that included radiomics signature and clinical risk factors to predict low intermediate and high recurrence risk of ER-positive, LN-negative invasive breast cancer in the training set. The models were evaluated with the receiver operating characteristic curve in the training set. The internal and external test sets were used to confirm the discriminatory power of the models. The clinical usefulness was evaluated by using decision curve analysis.

Results: The radiomics signature consisting of three radiomics features achieved favorable prediction performance. The multivariate logistic regression model including radiomics signature and clinical risk factors (tumor grade and HER 2) showed good performance with areas under the curve of 0.92 (95% confidence interval [CI] 0.86 to 0.97), 0.88 (95% CI 0.75 to 1.00), and 0.84 (95% CI 0.69 to 0.99) in the training, internal and external test sets, respectively. The DCA indicated that when the threshold probability is ranges from 0.1 to 1.0, the radiomics model adds more net benefit than the "treat all" or "treat none" scheme in internal and external test sets.

Conclusion: As a non-invasive pre-operative prediction tool, the mammography-based radiomics model incorporating radiomics and clinical factors show favorable predictive performance for predicting the risk of ER-positive, LN-negative invasive breast cancer recurrence based on Oncotype DX.

Advances In Knowledge: The mammography-based radiomics model incorporating radiomics and clinical factors shows favorable predictive performance for predicting the risk of ER-positive, LN-negative invasive breast cancer recurrence.
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http://dx.doi.org/10.1259/bjr.20210348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553203PMC
November 2021

Clinical Relevance and Management of Recurrent Laryngeal Nerve Inlet Zone Lymph Nodes Metastasis in Papillary Thyroid Cancer.

Front Endocrinol (Lausanne) 2021 22;12:653184. Epub 2021 Jul 22.

Department of Otolaryngology-Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.

Background: Recurrent nodal disease often occurs in recurrent laryngeal nerve inlet zone (RLNIZ), leading to difficult surgical management.

Methods: Medical records of 947 patients with PTC and 33 patients with recurrent PTC were retrospectively reviewed. Totally 169 sides of RLNIZ dissection in 152 patients (17 cases were bilateral and 135 cases were unilateral) with primary surgery and 4 patients with structural recurrent disease were included for the analysis.

Results: The rate of lymph node metastasis in RLNIZ was 31.3% (47/150). The incidence of transient hypoparathyroidism was 5.9% and no RLN injury and permanent hypoparathyroidism occurred. RLNIZ lymph nodes metastasis (LNM) was significantly associated with age <45 years, larger tumor size, number of CNLNM, and lateral node metastasis. CNLNM and lateral node metastasis were independent risk factors for RLNIZ LNM. Recurrent nodal disease in RLNIZ was identified in four of 33 patients and permanent recurrent laryngeal nerve (RLN) injury was observed in one of four patients.

Conclusion: Lymph nodes in RLNIZ are usually involved in patients with heavy tumor burden and can be removed safely at initial surgery. Once central or lateral LNM was confirmed preoperatively or intraoperatively, RLNIZ lymph node dissection should be carefully performed to reduce the rate of structural recurrence in the central compartment.
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http://dx.doi.org/10.3389/fendo.2021.653184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339313PMC
December 2021

An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report.

BMC Pulm Med 2021 Jul 31;21(1):254. Epub 2021 Jul 31.

Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, China.

Background: Aspiration pneumonitis is an inflammatory disease of the lungs which is difficult to diagnose accurately. Large-volume aspiration of oropharyngeal or gastric contents is essential for the development of aspiration pneumonitis. The role of cerebrospinal fluid (CSF) rhinorrhea is often underestimated as a rare etiological factor for aspiration in the diagnosis process of aspiration pneumonitis.

Case Presentation: We present a case of a patient with 4 weeks of right-sided watery rhinorrhea accompanied by intermittent postnasal drip and dry cough as the main symptoms. Combined with clinical symptoms, imaging examination of the sinuses, and laboratory examination of nasal secretions, she was initially diagnosed as spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, and intraoperative endoscopic findings and postoperative pathology also confirmed this diagnosis. Her chest computed tomography showed multiple flocculent ground glass density shadows in both lungs on admission. The patient underwent endoscopic resection of meningoencephalocele and repair of skull base defect after she was ruled out of viral pneumonitis. Symptoms of rhinorrhea and dry cough disappeared, and pneumonitis was improved 1 week after surgery and cured 2 months after surgery. Persistent CSF rhinorrhea caused by spontaneous sphenoid sinus meningoencephalocele was eventually found to be a major etiology for aspiration pneumonitis although the absence of typical symptoms and well-defined risk factors for aspiration, such as dysphagia, impaired cough reflex and reflux diseases.

Conclusions: We report a rare case of aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, which can bring more attention and understanding to the uncommon etiology for aspiration, so as to make more accurate diagnosis of the disease and early surgical treatment.
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http://dx.doi.org/10.1186/s12890-021-01620-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325533PMC
July 2021

The sensorimotor changes of the lower lip and chin after transoral endoscopic thyroidectomy vestibular approach.

Updates Surg 2021 Dec 21;73(6):2283-2291. Epub 2021 Jul 21.

Department of Otolaryngology Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, China.

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) can lead to abnormal sensorimotor changes in the lower lip and chin because of its incision design. This study aimed to explore the surgical outcomes of these changes after TOETVA. A total of 122 patients who underwent TOETVA were reviewed. The original incision design was used for the 39 patients in group A and a modified incision design was used for the 83 patients in group B. The sensorimotor changes in the lower lip and chin were compared. Varying degrees of paresthesia of the lower lip and chin (PoLC) were noted in all group A patients. Approximately 20.5% of group B patients did not suffer from PoLC, and the degree of PoLC in group B was significantly lower (P < 0.001). Abnormal motor function of the lower lip was noted for 23.1% of the patients in group A and 2.4% of those in group B. The incision design plays an important role in the morbidity of sensorimotor changes in the lower lip and chin. Our modified incision design seems minimally invasive and feasible for patients who undergo TOETVA.
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http://dx.doi.org/10.1007/s13304-021-01133-0DOI Listing
December 2021

Radiomics Nomogram for Identifying Sub-1 cm Benign and Malignant Thyroid Lesions.

Front Oncol 2021 7;11:580886. Epub 2021 Jun 7.

Department of Otorhinolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Purpose: To develop and validate a radiomics nomogram for identifying sub-1 cm benign and malignant thyroid lesions.

Method: A total of 171 eligible patients with sub-1 cm thyroid lesions (56 benign and 115 malignant) who were treated in Yantai Yuhuangding Hospital between January and September 2019 were retrospectively collected and randomly divided into training (n = 136) and validation sets (n = 35). The radiomics features were extracted from unenhanced and arterial contrast-enhanced computed tomography images of each patient. In the training set, one-way analysis of variance and least absolute shrinkage and selection operator (LASSO) logistic regression were used to select the features related to benign and malignant lesions, and the LASSO algorithm was used to construct the radiomics signature. Combined with clinical independent predictive factors, a radiomics nomogram was constructed with a multivariate logistic regression model. The performance of the radiomics nomogram was evaluated by using the receiver operating characteristic (ROC) and calibration curves in the training and validation sets. The clinical usefulness was evaluated by using decision curve analysis (DCA).

Results: The radiomics signature consisting of 13 selected features achieved favorable prediction efficiency. The radiomics nomogram, which incorporated radiomics signature and clinical independent predictive factors including age and Thyroid Imaging Reporting and Data System category, showed good calibration and discrimination in the training (area under the ROC [AUC]: 0.853; 95% confidence interval [CI]: 0.797, 0.899) and validation sets (AUC: 0.851; 95% CI: 0.735, 0.931). DCA demonstrated that the nomogram was clinically useful.

Conclusion: As a noninvasive preoperative prediction tool, the radiomics nomogram incorporating radiomics signature and clinical predictive factors shows favorable predictive efficiency for identifying sub-1 cm benign and malignant thyroid lesions.
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http://dx.doi.org/10.3389/fonc.2021.580886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215667PMC
June 2021

Comprehensive Analysis of the Diagnosis and Treatment of Tracheobronchial Foreign Bodies in Children.

Ear Nose Throat J 2021 Jun 10:1455613211023019. Epub 2021 Jun 10.

Department of Otolaryngology-Head and Neck Surgery, 117747Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.

Objective: To analyze the factors influencing the diagnosis and treatment of tracheobronchial foreign bodies (TFBs) in children.

Methods: The clinical data of 300 consecutive children with suspected TFBs who were admitted to our department between January 2016 and December 2019 were retrospectively collected, including demographics, diagnosis, history of foreign body inhalation, preoperative chest computed tomography (CT) findings, duration of foreign body retention, time from admission to operation, operation duration, duration of hospitalization, and complications.

Results: Among the 300 cases, the male:female ratio was 193:107, and the age range was 6 months to 12 years (median age: 19 months). A total of 291 cases (97.0%) involved TFBs confirmed by rigid bronchoscopy, while the other 9 cases (3.0%) involved bronchopneumonia. The diagnostic accuracy, sensitivity, and specificity of a history of foreign body inhalation and chest CT were 96.0%, 98.6%, and 11.1% and 97.7%, 97.6%, and 100%, respectively. The duration of hospitalization, time from admission to operation, and operation duration were all related to bronchopneumonia ( < .05).

Conclusions: A detailed history, adequate physical examination, and preoperative imaging examination help improve the diagnostic accuracy. Preoperative bronchopneumonia in children with TFBs will increase the surgical risks and treatment costs, prolonging the duration of hospitalization.
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http://dx.doi.org/10.1177/01455613211023019DOI Listing
June 2021

DNA methyltransferase 1 inhibits O-methylguanine-DNAmethyl-transferase-mediated cell growth and metastasis of hypopharyngeal squamous carcinoma.

Arch Oral Biol 2021 Aug 19;128:105160. Epub 2021 May 19.

Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, 264000, China. Electronic address:

Objective: To explore the role of DNA methyltransferase 1 (DNMT1) in development and progression of hypopharyngeal squamous carcinoma.

Design: A total of 32 hypopharyngeal squamous carcinoma biopsy samples and 20 normal tissue specimens were collected. Immunohistochemical staining, quantitative real-time polymerase chain reaction, and Western blot were performed for expression analysis. The mRNA and protein expression in the specimens and subcellular localization were analyzed. hypopharyngeal squamous carcinoma cells (FaDu) were used for small interfering RNA of DNMT1, and proliferation, cell cycle, and apoptosis were determined in the transfected cells. Furthermore, metastatic ability and methylation status of O-methylguanine-DNAmethyl-transferase (MGMT) promoter was assessed.

Results: Our results showed that DNMT1 was overexpressed, while MGMT was down expressed in hypopharyngeal squamous carcinoma. DNMT1 overexpression and MGMT down expression were significantly associated with poorly differentiated tumors, lymph node metastasis, and clinical stage. DNMT1 and MGMT were majorly distributed in the nucleus. Furthermore, knockdown of DNMT1 inhibited proliferation and metastasis, induced apoptosis and G1 phase arrest in FaDu cells, and upregulated MGMT expression to reverse methylation status of MGMT promoter.

Conclusions: This study for the first time demonstrated the clinical value and the role of DNMT1 and MGMT in the biological function of hypopharyngeal squamous carcinoma. This work suggested that DNMT1 might serve as a potential therapeutic target for patients with hypopharyngeal squamous carcinoma.
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http://dx.doi.org/10.1016/j.archoralbio.2021.105160DOI Listing
August 2021

Risk factors analysis and intervention of lung dysfunction in children with obstructive sleep apnea: A retrospective case series study.

Int J Pediatr Otorhinolaryngol 2021 Jul 15;146:110772. Epub 2021 May 15.

Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China. Electronic address:

Objectives: To establish an optimized airway management process to improve preoperative lung dysfunction in obstructive sleep apnea (OSA).

Methods: The study included 483 children (319 males and 164 females; 6y to14y years) with OSA who underwent an adenotonsillectomy from November 2017 to December 2018. Children with OSA and who had abnormal airway function were identified by lung function test, and the risk factors for abnormal lung function were assessed. Next, the children received individualized atomization intervention based on the severity of their abnormal lung function, and the improvement in lung function was evaluated.

Results: Lung function tests revealed that 45 patients had obstructive ventilation dysfunction, and histories of chronic cough or asthma were identified as risk factors for perioperative abnormal lung function. The FEV1% pre exceeded 80% after 2 days of atomization intervention in 27 of 28 mild cases, 4 of 13 moderate cases, but in none of the 4 moderate-severe cases. After 4 days of atomization intervention, the FEV1%pre of the remaining 14 patients in the three groups all increased up to 80%. Other indicators of lung function (e.g., FEV1/FVC% pre, MEF50% pre, MEF25% pre, and MMEF% pre) were also greatly improved following the improvement of FEV1% pre. No perioperative airway complications occurred.

Conclusions: Prior to performing surgery on children with OSA and who have risk factors associated with abnormal lung function, it is potentially beneficial to establish an optimized airway management process to improve lung function before adenotonsillectomy.
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http://dx.doi.org/10.1016/j.ijporl.2021.110772DOI Listing
July 2021

Central Retinal Artery Occlusion Due to Subperiosteal Orbital Abscess Caused by Acute Sinusitis in a Child: A Case Report.

Ear Nose Throat J 2021 May 12:1455613211016731. Epub 2021 May 12.

Department of Otolaryngology Head and Neck Surgery, 117747Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong Province, China.

Central retinal artery occlusion (CRAO) is an ophthalmic emergency and has poor visual prognosis. It is commonly found in elderly people and very rare in child. We reported an 8-year-old girl who suffered from acute sinusitis, periorbital swelling, and the visual acuity of her right eye was only light perception. She was diagnosed with CRAO, SPOA (subperiosteal orbital abscess), and acute sinusitis. Emergency treatments including surgery, antibiotics, glucocorticoids, intraocular-pressure-lowering drugs, and vasodilators were taken immediately in order to save the eyesight. The visual acuity of the right eye returned to 20/400. Conclusions: Severe intraorbital complications of acute sinusitis can lead to CRAO. Timely drainage, strong antibiotics, and glucocorticoids are the most effective methods for the treatments.
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http://dx.doi.org/10.1177/01455613211016731DOI Listing
May 2021

[Diagnosis and treatment of 11 cases of subperiosteal orbital abscess caused by acute sinusitis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Feb;35(2):125-130

Department of Otorhinolaryngology Head and Neck Surgery,Yantai Yuhuangding Hospital,Qingdao University,Yantai,264000,China.

The aim of this study is to explore the diagnosis, clinical manifestations and surgical treatment experience of acute sinusitis complicated with orbital subperiosteal abscess. The clinical data of 11 patients with acute sinusitis complicated by orbital subperiosteal abscess from 1 year and 8 months to 50 years were retrospectively analyzed, including clinical manifestations, imaging manifestations, bacteriological examinations, surgical methods and therapeutic effects. All patients were given antibacterial drugs, glucocorticoids, and surgery. All 11 patients had unilateral lesions. The imaging examinations all supported the appearance of orbital subperiosteal abscess. Nine patients underwent nasal endoscopic sinus opening+SPOA incision and drainage, 2 patients underwent nasal endoscopic sinus opening+ultrasound guided abscess puncture. Eyelid swelling and exophthalmia of all patients were alleviated when discharged. Ten of the 11 patients had no visual acuity change, and one patient had light perception only when she came to the hospital and recovered to 0.05 when discharged, there was no change in visual acuity after 3 months follow-up. The bacterial cultures of nasal secretion or pus were positive in 7 cases, the main pathogenic bacteria were Staphylococcus aureus(3 cases, includes one case of MRSA), Streptococcus anginosus(2 cases), and Streptococcus intermedius(2 cases). Rhinogenous orbital subperiosteal abscess has a rapid onset and progresses quickly. Once an abscess is formed, patients with poor conservative treatment should choose surgical treatment as soon as possible. The most common surgical method is nasal endoscopic sinus opening+SPOA incision and drainage. If the abscess is located above or above the eyeball, puncture or incision and drainage should be combined with ultrasound guidance.
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http://dx.doi.org/10.13201/j.issn.2096-7993.2021.02.008DOI Listing
February 2021

Endoscopic diagnosis value of narrow band imaging Ni classification in vocal fold leukoplakia and early glottic cancer.

Am J Otolaryngol 2021 May-Jun;42(3):102904. Epub 2021 Jan 8.

Department of Otolaryngology Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China. Electronic address:

Objectives: To explore the diagnostic value and the correlation between histological diagnosis and the Ni classification under narrow band imaging (NBI) for vocal fold leukoplakia (VFL) and early glottic cancer.

Methods: A total of 91 patients with 119 vocal fold lesions were selected from January 2017 to May 2020. All these patients were subsequently examined by white light imaging (WLI) and NBI endoscopy, and then all lesions were classified by the Ni classification according to the characteristics of intraepithelial papillary capillary loop (IPCL) observed. The gold standard of diagnosis was histopathological results. Eventually, the chi-square and kappa test were applied, respectively, to evaluate the diagnostic value of NBI endoscopy and the consistency of Ni classification and pathological results.

Results: The accuracy and sensitivity of NBI endoscopy were significantly higher than that of WLI endoscopy (P < 0.05). For the diagnosis of precancerous lesions under the NBI, the sensitivity, specificity, positive and negative predictive value were 69.6% (16/23), 90.6% (87/96), 64.0% (16/25) and 92.6% (87/94), which for malignant lesions were 84.4% (65/77), 92.9% (39/42), 95.6% (65/68) and 76.5% (39/51). Moreover, for patients with low-grade intraepithelial neoplasia (mild and moderate dysplasia), type IV lesions accounted for the most (69.6 vs 30.4%; χ = 36.961, P < 0.001). For high-grade intraepithelial neoplasia or carcinoma in situ, type Va lesions were predominant (χ = 30.526, P < 0.001), while type Vb and Vc lesions were dominant in invasive carcinoma (χ = 64.373, P < 0.001). Besides, the kappa test revealed that there was a high consistency between Ni classification and pathological diagnosis (Kappa = 0.667, P < 0.001).

Conclusions: The Ni classification can improve the diagnosis accuracy of vocal fold lesions which enables clear visualization of mucosal microvasculature. This is essential for the early diagnosis of VFL and early glottic cancer during routine endoscopic examination.
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http://dx.doi.org/10.1016/j.amjoto.2021.102904DOI Listing
October 2021

Expression of T helper cytokines associated with MUC5AC secretion in eosinophil-based endotypes of nasal polyps.

Allergy 2021 02 8;76(2):604-609. Epub 2020 Dec 8.

Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

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http://dx.doi.org/10.1111/all.14669DOI Listing
February 2021

An enhanced recovery programme improves the comfort and outcomes in children with obstructive sleep apnoea undergoing adenotonsillectomy: A retrospective historical control study.

Clin Otolaryngol 2021 Jan 7;46(1):249-255. Epub 2020 Nov 7.

Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.

Objective: To explore the effects of an enhanced recovery after surgery (ERAS) programme on postoperative rehabilitation in children with obstructive sleep apnoea (OSA) during the perioperative period of adenotonsillectomy.

Design: A retrospective historical control study.

Setting: Service improvement project.

Participants: The study included 394 children with OSA (207 males, 187 females; age range, 2.5 years to 14 years) who underwent adenotonsillectomy.

Main Outcome Measures: The children who had undergone adenoidal ablation and bilateral tonsillectomy were divided into an ERAS group (208 patients) treated with the combined optimisation measures and a control group (186 patients) treated with traditional measures during the perioperative period. The postoperative incidence of complications, pain scores, anxiety scores and postoperative diets in the two groups were assessed.

Results: Patients in the ERAS group had significantly a lower overall complication rate and incidence of fever for 2 weeks of follow-up when compared to patients in the control group through the application of perioperative optimisation measures. Furthermore, patients in the ERAS group had less post-surgical pain, had better dietary intake at days 1, 3 and 7 after surgery and had lower preoperative anxiety scores after admission education and while waiting in the operation room.

Conclusion: The ERAS programme consisting of combined optimisation measures can reduce physical and psychological trauma during the perioperative period of adenotonsillectomy performed for children with OSA.
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http://dx.doi.org/10.1111/coa.13655DOI Listing
January 2021

Differential Expression of Long Noncoding RNAs and Their Function-Related mRNAs in the Peripheral Blood of Allergic Rhinitis Patients.

Am J Rhinol Allergy 2020 Jul 13;34(4):508-518. Epub 2020 Mar 13.

Department of Otolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.

Background: The mechanism of long noncoding RNAs (lncRNAs) involved in the development of allergic rhinitis (AR) remains unclear.

Objective: We investigated the mechanism by which differentially expressed lncRNAs contribute to pathogenesis of AR.

Methods: Expression profiles of lncRNAs and mRNAs were analyzed by microarray detection from the blood samples of 3 AR patients and 3 control subjects, and the main lncRNAs were verified by quantitative real-time polymerase chain reaction (qRT-PCR) in the peripheral blood of 16 AR patients and 18 control subjects. GO (Gene_Ontology), Pathway, and Disease analysis of differentially expressed lncRNAs and mRNAs, and transcription factor prediction analysis were performed to explore synergistic effect of differentially expressed lncRNAs and their function-related mRNAs on AR pathogenesis.

Results: Thirty-one lncRNAs were differentially expressed in the peripheral blood from AR patients, and 4 of the 5 most differentially expressed lncRNAs had significantly higher levels in AR patients than in control subjects by qRT-PCR analysis. A lncRNA-mRNA coexpression network analysis identified 16 pairs of positive correlations between the 4 lncRNAs and coexpressed mRNAs. GO, Pathway, and Disease analyses indicated that the 4 lncRNAs were correlated with 7 mRNAs enriched in terms of inflammation, immune response, and allergic diseases. Transcription factor prediction results suggested that Oct-1, AP-1, NF-kappaB, and c-Rel play key roles in the pathogenesis of AR mediated by lncRNAs.

Conclusion: Our results provide new insights into how lncRNAs and their function-related mRNAs might contribute to AR.
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http://dx.doi.org/10.1177/1945892420912164DOI Listing
July 2020
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